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All about: NuvaRing Ring

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Generic Name: Etonogestrel/Ethinyl Estradiol Vaginal Ring (et-oh-noe-JES-trel/ETH-in-il ess-trah-DYE-ole)
Brand Name: NuvaRing

Cigarette smoking while taking NuvaRing Ring increases the risk of serious heart problems. The risk increases with age (older than 35 years) and with heavy smoking (15 or more cigarettes per day). Patients who use NuvaRing Ring are strongly advised not to smoke.


NuvaRing Ring is used for:

Preventing pregnancy. It may also be used for other conditions as determined by your doctor.

NuvaRing Ring is an estrogen/progestin combination. It works by preventing the release of eggs from the ovaries and thereby preventing pregnancy.

Do NOT use NuvaRing Ring if:

  • you are allergic to any ingredient in NuvaRing Ring
  • you are pregnant or think you may be pregnant
  • you have blood clots in the legs, lungs, or eyes; or a history of heart attack, chest pain, or stroke
  • you have heart valve problems with blood clotting complications
  • you have known or suspected breast cancer or cancer of the lining of the uterus, cervix, or vagina, or have had vaginal bleeding of unknown causes
  • you have a liver tumor or active liver disease, or a history of yellowing of the eyes or skin during pregnancy or previous birth control use
  • you have headaches with neurological symptoms or will be on bed rest for a long period following surgery

Contact your doctor or health care provider right away if any of these apply to you.

Before using NuvaRing Ring:

Some medical conditions may interact with NuvaRing Ring. Tell your health care provider if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have high blood pressure; high cholesterol, triglycerides, or calcium levels; heart valve problems; pancreatitis or gallbladder problems; or are obese
  • if you have breast nodules, fibrocystic disease of the breast, an abnormal breast x-ray or mammogram, endometriosis or endometrial carcinomas, uterine fibroids, prolapsed uterus, or irregular or scanty menstrual periods
  • if you have diabetes, headaches, migraine headaches, epilepsy, or a history of mental depression or toxic shock syndrome (TSS)
  • if you are having surgery
  • if you are a heavy smoker (15 or more cigarettes per day), especially if you are older than 35 years of age

Some MEDICINES MAY INTERACT with NuvaRing Ring. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Azole antifungals (eg, itraconazole), aprepitant, bosentan, barbiturates (eg, phenobarbital), carbamazepine, felbamate, griseofulvin, HIV protease inhibitors (eg, ritonavir), hydantoins (eg, phenytoin), modafinil, nevirapine, oxcarbazepine, penicillins (eg, amoxicillin), phenylbutazone, rifampin, St. John's wort, tetracyclines (eg, doxycycline), topiramate, and troglitazone because decreased effectiveness of NuvaRing Ring may be increased by these medicines. Alternative forms of birth control are strongly recommended when taking any of these medicines along with this birth control medicine.
  • Beta-blockers (eg, atenolol), selegiline, theophyllines (eg, aminophylline), and troleandomycin because side effects may be increased by NuvaRing Ring
  • Lamotrigine because the effectiveness may be decreased by NuvaRing Ring

This may not be a complete list of all interactions that may occur. Ask your health care provider if NuvaRing Ring may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use NuvaRing Ring:

Use NuvaRing Ring as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with NuvaRing Ring. Talk to your pharmacist if you have questions about this information.
  • Wash and dry your hands before removing the ring from the pouch. The ring becomes slippery when wet, so make sure your hands are dry.
  • To insert the ring, choose a comfortable position, such as lying down, squatting, or standing with one leg up. Hold the ring between your thumb and index finger and press the opposite sides of the ring together. Gently insert and push the folded ring into the vagina as far as comfortably possible. The exact position of the ring is the vagina is not important for it to work.
  • You may not feel the ring once it is in place. If you feel discomfort, the ring is probably not inserted far enough in your vagina. Use your finger to gently push the ring further into your vagina. There is no danger in the ring being pushed too far up the vagina or getting lost. It can be inserted only as far as the end of the vagina. The cervix will block it from going any further.
  • The ring should not interfere with sexual intercourse.
  • Some women have experienced moving or gliding of the ring within the vagina due to bowel movements, straining, constipation, or coughing. If this occurs, push it back into place with your finger.
  • After insertion, the ring should be left in place for 3 weeks (21 days) and then removed. It should be removed at about the same time and on the same day of the week that it was inserted. To remove the ring, wash and dry your hands thoroughly. Find a comfortable position, either standing, squatting, or lying down. Loop your finger through the ring and gently pull it out. Discard the used ring in the trash container. Do not flush it down the toilet.
  • After removing the ring, wait 7 days and then insert a new ring. The new ring should be inserted at about the same time and on the same day of the week as it was inserted in the last cycle.
  • If the ring is removed or falls out of the vagina and remains out for less than 3 hours, rinse the ring with lukewarm water and reinsert it. No other contraceptive measures are necessary.
  • If the ring is removed or falls out of the vagina and remains out for more than 3 hours, rinse the ring with lukewarm water and reinsert it. In this case, you may not be adequately protected from pregnancy. You must use an additional form of birth control (eg, male condoms, spermicide) until the ring has been in place for 7 days in a row.
  • If the ring is removed or falls out and is lost, or if the ring becomes disconnected at the joint, you must insert a new ring and use it on the same schedule as you would have used the lost or disconnected ring.
  • If you forget and have not inserted a new ring at the appropriate time, contact your doctor to establish a new schedule for NuvaRing Ring.

Ask your health care provider any questions you may have about how to use NuvaRing Ring.

Important safety information:

  • NuvaRing Ring may cause dizziness or changes in vision. These effects may be worse if you take it with alcohol or certain medicines. Use NuvaRing Ring with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • If you miss your period, call your doctor immediately. A missed period may indicate that you are pregnant.
  • NuvaRing Ring may cause dark skin patches on your face. Exposure to the sun may make these patches darker. If patches develop, use a sunscreen or protective clothing when exposed to the sun, sunlamps, or tanning booths.
  • Follow your doctor's instructions for examining your breasts, and report any lumps immediately.
  • NuvaRing Ring may interfere with certain lab tests. Be sure your doctor and lab personnel know you are using this medicine.
  • If you will be having surgery or will be confined to a chair or bed for a long period of time (such as a long plane flight), notify your doctor 3 to 4 weeks beforehand. Special precautions may need to be taken in these circumstances while you are taking NuvaRing Ring.
  • Bleeding or spotting may occur while taking NuvaRing Ring. Do not stop taking NuvaRing Ring if this occurs. If bleeding or spotting continues for more than 7 days or is heavy, contact your doctor.
  • NuvaRing Ring may increase the risk of stroke, heart attack, blood clots, high blood pressure, or similar problems. The risk may be greater if you smoke.
  • Taking certain antibiotics or anticonvulsants while you are using NuvaRing Ring, or vomiting or diarrhea may decrease the effectiveness of NuvaRing Ring. To prevent pregnancy, use an additional form of birth control (such as condoms, spermicide, diaphragm) until your next period. If you have any questions, contact your doctor or pharmacist.
  • If you wear contact lenses and you develop problems with them, contact your doctor.
  • Use of NuvaRing Ring will not prevent the spread of sexually transmitted diseases (STDs).
  • Lab tests, including physical exams and blood pressure, may be performed while you use NuvaRing Ring. You should have breast and pelvic exams, and a Pap test at least once a year. You should also have periodic mammograms as determined by your doctor. Be sure to keep all doctor and lab appointments.
  • NuvaRing Ring should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: Do not use NuvaRing Ring if you are pregnant. If you think you may be pregnant, contact your doctor right away. Continue to use another method of birth control (such as condoms). NuvaRing Ring is found in breast milk. Do not breast-feed while you are taking NuvaRing Ring. Do not take NuvaRing Ring soon after delivery of a baby even if you are not breast-feeding. You should wait 4 weeks after delivery if you are not breast-feeding or 4 weeks after a second trimester abortion.

Possible side effects of NuvaRing Ring:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Brief, minor spotting between menstrual periods; change in appetite; change in menstrual flow; headache; nausea; reduction of breast milk when given right after childbirth; spotty darkening of the skin, especially the face; stomach cramps or bloating; weight change.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloating; breast lumps; breast tenderness; calf/leg pain or swelling; changes in vision; chest pain or heaviness in the chest; coughing up blood; difficulty wearing contact lenses; dark urine or light-colored bowel movements; dizziness or fainting; fever; loss of appetite; loss of scalp hair; missed menstrual period; mood or mental changes; muscle aches; numbness of an arm or leg; persistent or recurrent abnormal vaginal bleeding; severe pain or tenderness in the stomach area; sleeplessness; slurred speech; sudden severe headache (migraine); sudden shortness of breath, vomiting, or diarrhea; sunburn-like rash; swelling of fingers or ankles; vaginal infection; vomiting; weakness or fatigue; weakness or numbness in the arm or leg; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms of overdose may include nausea or vomiting; vaginal bleeding.

Proper storage of NuvaRing Ring:

Store NuvaRing Ring at room temperature, below 86 degrees F (30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep NuvaRing Ring out of the reach of children and away from pets.

General information:

  • If you have any questions about NuvaRing Ring, please talk with your doctor, pharmacist, or other health care provider.
  • NuvaRing Ring is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about NuvaRing Ring. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: September 5, 2007
Database Edition 07.3.1.003
Copyright © 2007 Wolters Kluwer Health, Inc.

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